How To Use CPT Code 11055

CPT 11055 refers to the paring or cutting of a single benign hyperkeratotic lesion, such as a corn or callus. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 11055 procedures.

1. What is CPT 11055?

CPT 11055 is a medical code used to describe the paring or cutting of a single benign hyperkeratotic lesion, such as a corn or callus. This procedure is performed by a healthcare provider using surgical instruments like a scalpel or curette to remove the lesion.

2. 11055 CPT code description

The official description of CPT code 11055 is: “Paring or cutting of benign hyperkeratotic lesion (e.g., corn or callus); single lesion.”

3. Procedure

The 11055 procedure involves the following steps:

1. The patient is appropriately prepped and anesthetized.
2. The provider evaluates the size, depth, and location of the benign hyperkeratotic lesion.
3. Using a scalpel, curette, blade, or a spoon-shaped surgical instrument, the provider trims or pares down the lesion.
4. Antiseptic is applied to the site.
5. If necessary, the provider removes pressure points by fitting padding on the site.

4. Qualifying circumstances

Patients eligible to receive CPT code 11055 services are those with a single benign hyperkeratotic lesion, such as a corn or callus, that requires paring or cutting. The lesion must be causing discomfort or pain, or be at risk of causing complications if left untreated. The patient’s medical history, physical examination, and any relevant diagnostic tests should support the need for this procedure.

5. When to use CPT code 11055

It is appropriate to bill the 11055 CPT code when a healthcare provider performs the paring or cutting of a single benign hyperkeratotic lesion, such as a corn or callus, on a patient who meets the qualifying circumstances mentioned above. The procedure should be medically necessary and supported by the patient’s medical history, physical examination, and any relevant diagnostic tests.

6. Documentation requirements

To support a claim for CPT 11055, the following information should be documented:

• Patient’s medical history, including any previous treatments for the lesion
• Physical examination findings, including the size, depth, and location of the lesion
• Any relevant diagnostic tests, such as imaging studies, that support the need for the procedure
• A detailed description of the procedure performed, including the instruments used and the steps taken
• Post-procedure care instructions and any follow-up appointments scheduled

7. Billing guidelines

When billing for CPT code 11055, it is important to follow the appropriate guidelines and rules. Some tips and codes that apply to CPT code 11055 include:

• Use CPT code 11056 for services involving 2 to 4 lesions
• Use CPT code 11057 for services involving more than 4 lesions
• Do not use CPT codes 11055, 11056, or 11057 to report the destruction of skin tags or cutaneous vascular proliferative lesions (see CPT codes 17110 and 17111)

8. Historical information

CPT 11055 was added to the Current Procedural Terminology system on January 1, 1998. There have been no updates to the code since its addition.

9. Similar codes to CPT 11055

Five similar codes to CPT 11055 and how they differentiate from CPT 11055 are:

• CPT 11056: Involves the paring or cutting of 2 to 4 benign hyperkeratotic lesions
• CPT 11057: Involves the paring or cutting of more than 4 benign hyperkeratotic lesions
• CPT 17110: Involves the destruction of benign lesions other than skin tags or cutaneous vascular proliferative lesions
• CPT 17111: Involves the destruction of cutaneous vascular proliferative lesions
• CPT 10060: Involves the incision and drainage of an abscess, which is a different type of lesion than a corn or callus

10. Examples

Here are 10 detailed examples of CPT code 11055 procedures:

1. A patient with a painful corn on the sole of their foot undergoes paring of the lesion using a scalpel.
2. A patient with a large callus on their heel has the lesion pared down using a curette.
3. A patient with a corn on their toe receives paring of the lesion with a blade.
4. A patient with a callus on the ball of their foot undergoes paring using a spoon-shaped surgical instrument.
5. A patient with a painful corn on their little toe has the lesion pared down using a scalpel and receives padding to relieve pressure points.
6. A patient with a callus on the side of their foot undergoes paring with a curette and has antiseptic applied to the site.
7. A patient with a corn on the top of their toe receives paring of the lesion using a blade and has the pressure points removed with padding.
8. A patient with a callus on their big toe undergoes paring using a spoon-shaped surgical instrument and receives antiseptic treatment on the site.
9. A patient with a painful corn on their second toe has the lesion pared down using a scalpel and has pressure points removed with padding.
10. A patient with a callus on the arch of their foot undergoes paring with a curette and has antiseptic applied to the site.